The newer batch of pictures comes from the vacant old Cook County Hospital structure, in the Illinois Medical District near its replacement, Stroger Hospital. The hospital achieved national fame as the inspiration for the County General of the fictional TV series, ER.

I'm not sure of the current status of this building. It was slated for demolition some years ago, and remains on the National Trust for Historic Preservation's list of endangered places.

The land is valuable, and the Classical Revival exterior beautiful, with all that glazed terra cotta ornamentation. Nobody builds hospitals like that anymore. None of the proposals I've seen for rehabbing the structure involve health-care uses.

It's disturbing that the photographer and his friends were able to gain access so easily. As he documents in the blog and the accompanying Flickr stream, parts of the interior were still in fairly good condition in 2008. A few squatters or vandals could do untold amounts of damage. I'm wondering if the cash-strapped county ever called in an architectural salvage firm for bids. Some of the abandoned elements might have value, or at least they would have when the hospital closed seven years ago.

The earlier series is even more disturbing, however. It shows Edgewater Medical Center, birthplace of John Wayne Gacy and Hillary Rodham Clinton, which was shuttered in 2001 after members of its management and medical staff were convicted of massive Medicare fraud. When the building was abandoned, its patients' medical records were apparently just left behind.

Saturday, May 30, 2009

When Barack Obama promised "change," I didn't realize he meant the kind that goes ka-ching ... in the pockets of politicians.

Yet he's done absolutely nothing to resist the influence of monied lobbyists on Washington. I suppose that's too much to ask of an Illinois pol.

First, all the bailouts that paid insurance executives bonuses and let them go on luxury retreats. Now, a retreat from real health-care reform.

Now that he's the seat of all the money and power in Washington, Obama has turned away from the health-reform goals he once told us he believed in. He's barely involved himself personally in the debate, instead turning the crafting of health-care policy over to Sen. Max BauCASH, who's clearly been paid for by Big Medicine and the insurance industry, and he's tolerated the almost complete silencing of advocates for single-payer.

That's wrong. Maybe Congress is so venal that nothing we can say will make them vote for what's best for America's health; maybe they're all bought and paid for. I don't know. But not to permit open speech on the subject, not to let people who represent the opinions of millions of Americans speak on the same platforms as the profiteers who have sickened both our health and our economy, that's criminal.

Far more criminal than the valiant doctors and nurses BauCASH had hauled off to jail for trying to have their say.

Now, Obama says, mealymouthed: "If I were starting a system from scratch then I think that the idea of moving toward a single-payer system could very well make sense. That's the kind of system that you have in most industrialized countries around the world. The only problem is that we're not starting from scratch."

Americans need to let our president know that we won't stand for this. We need to shout — and keep shouting — that we want the single-payer, universal health care that Obama promised us back when he was a state senator — if only we could take back the White House, the Senate and the House. Well, we've done that for him.

As for starting from scratch, isn't that what change is supposed to be about?

SPEAKERS FROM: Chicago Single-Payer Action Network, California Nurses Association and Physicians for a National Health Program

The crisis in health care is worse than ever. Millions of people have lost their jobs and with it health insurance because of the economic crisis. Now over 50 million have no health insurance. The Institute of Medicine estimates that 22,000 die every year due to lack of access to health care.

President Obama and Senator Max Baucus have excluded the voices of single-payer supporters in the national discussion on health care reform. They said a single-payer system is "off the table" but then say all viewpoints are being heard in Washington. That's why 8 doctors disrupted a recent senate hearing on health care reform and demanded advocates of single-payer be at the table.

The majority of people and doctors in the this country want single-payer, a government financed system that gets rid of the private insurance industry once and for all.

Join us in a national day of action to raise our voices in support of single-payer.

Wednesday, May 27, 2009

Health Care for America Now!'s Illinois chapter struggles with blogging. First, they forgot to turn off the default list of Wordpress links; then, they had a variety of formatting troubles. They post infrequently. They have yet to figure out how to use categories or tags, and currently when you try to leave a comment, the blog reports: "ERROR: It looks like the website administrator hasn't activated the Brians Threaded Comments plugin from the plugin page."

Since I have twice e-mailed them in the past with bug reports and offers to help and haven't received so much as an acknowledgment, I'm not going to bother again.

The post I was trying to reply to is of interest, however. As you may know, one of the stupid ideas floating around Washington right now is a proposal for a "trigger" that would only put a public insurance option in place if competition among private insurance companies drops below a set level. HCAN has a new report showing that we already lack competition in the Illinois health insurance marketplace, leading to skyrocketing premiums for both patients and employers.

"The report shows how a handful of private health insurance companies have built a near-monopoly in the Illinois market, burdening families and businesses with premiums that grew 5.6 times faster than wages from 2000 to 2007. Illinois' two largest health insurers control 67% share of the market. Under a competition rating system used by the U.S. Justice Department, the Illinois market is "concentrated." The local markets are even worse for Rockford (82%), Bloomington-Normal (87%), and Champaign-Urbana (83%) where the US Justice Department considers these local markets 'highly concentrated.'"

HCAN-IL has unfortunately headed this with the title, "New Report Details Need for Competition in Illinois Health Insurance Market," which is not only boring, but also a wrong-headed conclusion. (HCAN, though right in their condemnation of the insurance industry's foul business practices, is cowardly in their proposals for reform. They believe the public option is the best we can hope for, and they don't think one's reach ought to exceed one's grasp.)

Here's the reply I'd have made if they'd had their comments working:

While I'm sure your data is correct, I disagree with your conclusions. What your report indicates is a need to do away with private insurance altogether, and replace it with a cost-effective, comprehensive, single-payer system that avoids the layers of waste and profiteering implicit in the health-insurance industry.

The public option plan is already a weak compromise, not real health reform, and the "trigger" is an abysmal idea that will continue to stop Americans from getting health care.

Monday, May 18, 2009

Over at The Covert Rationing Blog, the eccentric DrRich, who likes to refer to himself in the third person, takes a backwards look at the failed health-reform efforts of the Clinton administration, explains why things are different today, and gleefully contemplates the idea that the Obama team may find themselves confronting the R word.

So?

I'm not old enough to have lived through rationing in this country, but I've done a lot of reading, and I don't exactly understand why rationing is such a dirty word, even when applied to health care. It's not something for those of us who aren't insured now to worry about, because any health-care system that formalized rationing would give us more than we're getting now. Some 22,000 of us die each year for no good reason.

If rationing means that more of the terminally ill die with dignity, instead of being subjected to futile extreme measures so their families can quell their consciences, I have no qualms. If it means that, instead of getting elective surgery on demand, some people have to wait a little while, I'm unsympathetic. The poor and the uninsured are waiting much longer now.

As for those who can now buy whatever kind of health care they desire, well, surely no one is naive enough to believe that reforms will stop the rich from getting what they want. Where there is rationing, there are black markets.

No matter what happens in health reform, I assume there will continue to be exclusive private clinics where the wealthy can have their tummies tucked and their boobs lifted, and no doubt some of them will branch out to other services if there's money in it. Medical tourism will continue to boom, too. The rich will always get all the medical treatment they demand, just as they do even in countries with full-blown socialized medicine (a system that no one here is seriously advocating).

And what of the middle-class — that portion of them, anyway, who've managed to hang on to their jobs and benefits? How will reform — with, perhaps, the dreaded rationing — affect them?

Thursday, May 14, 2009

Do No Harm, a documentary about the struggle, against relentless attacks, of two reluctant Georgia whistleblowers to draw national attention to hospital corruption and the plight of the uninsured, gets its Chicago premiere Thursday, May 21, at the Museum of Contemporary Art, 220 E. Chicago Ave., Chicago.

The event opens at 6 p.m. with a reception at Puck's at the MCA. Illinois Attorney General Lisa Madigan will introduce the film. After the screening, a panel discussion will feature Dr. Quentin Young, founder of Physicians for a National Health Program and an advocate for single-payer health care; Mark Rukavina, executive director of The Access Project, whose research has uncovered unfair hospital billing and collection issues; and Donna Smith, founder of American Patients United, an organization whose members believe access to quality health care is a human right.

The film focuses on Phoebe Putney, a nonprofit hospital in Albany, Ga. In 2003, Dr. John Bagnato and accountant Charles Rehberg stumbled on evidence that the hospital overcharged uninsured and indigent patients, using aggressive collections tactics to recover costs. Investigation showed, that despite receiving huge tax breaks, the hospital held millions of dollars in offshore bank accounts and for-profit businesses under its control — and the same went for nonprofit hospitals across the country, while providing minimal charity care. (In other cases, Urbana's Provena Covenant Medical Center lost its tax-exempt status, and the Chicago-area's Advocate Health Care and Resurrection Health Care networks were the subject of class-action lawsuits.)

When they made their discoveries public, Bagnato and Rehberg became the targets of threats and intimidation.

Monday, May 11, 2009

When I spent 11 hours in the waiting room of Stroger Hospital's emergency department, it was December. The elections were not long over, and many of my fellow patients, waiting so stoically for treatment during the long hours, still sported hats, buttons and other paraphernalia from the campaign. As you might guess, no one needing care at the county hospital was promoting McCain.

Last week, I was at Stroger again, this time for a long-awaited visit to a specialty clinic. I'll save the details for another time, but as I waited there — I noticed that a few other patients were still wearing Obama 2008 gear. Now, when you're sick and standing in in a long, slow line outside a laboratory, waiting your turn to have blood drawn and pee in a cup, it's not the best time to engage in political discussion, but I tried to talk about health reform a little.

Friday, May 8, 2009

Washington's cold shoulder to single-payer health care is bad enough, but the media's failure to cover it is inexcusable. Eight people, representing organizations that 20 million Americans belong to, were arrested at Tuesday's Senate Finance Committee hearing — protesting that not one single-payer advocate was invited — and as far as I can tell, no major news organization covered it with more than a few paragraphs, if that. Not nationally, not here in Chicago, where Physicians for a National Health Program, one of the sponsors of the protest, is based, and not in the cities the protesters are from. Of course, I don't know where they're from, because no news account told me. None mentioned that the protesters were arrested, not merely ejected.

This Op-Ed on MSNBC's The Ed Schultz Show is the only major media attention to the event I've been able to find.

I know the media are currently preoccupied with intensive navel gazing over the dying news industry, but let me tell you, journalists, you'd better get out there and cover issues people care about before you're out on the street with no health insurance, like me. Go down to Stroger Hospital and spend a day in the ER seeing what it's like.

Meanwhile, I do wonder how well single-payer advocates are engaging the media on the issue. Were news media alerted this protest was going to happen? Were press releases sent out afterward, detailing who was arrested and their bios? (I'm not seeing this information on the websites of the organization involved.) Were releases sent to hometown newspapers as well as network TV? Are advocates creating relationships with reporters and giving them timely information and news? As in anything else, squeaky wheels get the grease in news coverage.

Monday, May 4, 2009

William T. Foley was slated to start today as CEO of the Cook County Health and Hospitals System. That's the newly independent, reorganized Cook County Bureau of Health Services, the organization that runs the county's public hospitals — Stroger, Oak Forest and Provident — and other health services.

According to Crain's, Foley will be paid $500,000 a year. Chi-Town Daily News puts that in a mid-range for the job, and had some positive things to say about Foley's experience. When Foley started as president and CEO of Provena Health in Mokena in 2001, that system was operating at a $28.4 million loss. Under Foley's guidance, it grew to an operating gain of $24.5 million in 2003.

Foley's CV paints him as a turnaround expert. I hope he's as good as he looks. With already overflowing hospitals further stressed by rapidly rising numbers of uninsured Cook County residents, a deficit of so many millions of dollars that system commissioners aren't even sure how deep it goes, and the corruption and conflicts of interest that plague nearly all Illinois public agencies, he's got a huge job.

I haven't the least idea what all is involved in Foley's job. I do hope, however, that his focus will be not only on improving Cook County Health's financial picture but also on expanding its services and level of care. Too many sick people are waiting too long.

May 11: The Chicago chapter of the Progressive Democrats of America hosts a discussion, "Which Way to Universal Health Care: Public Option or Single Payer?" with John Gaudette of Health Care for America Now! and Dr. Anne Scheetz of PDA, 6:30 p.m., Brehon Pub, 731 N. Wells St., Chicago. E-mail for more information.